Remote Utilization Review Rn Jobs in Wailuku, HI

Title: HIM Hospital Coder.
Location: Remote/Relocation position
Job Description:
PFB job details for HIM Hospital Coder. They are looking for a coder that understands coding from scratch, not someone who only can edit codes.
Pain point:
People are struggling to code with accuracy. That's the biggest problem. They need people who are actually coding, not just doing edits.
Location:
Hawaii (Remote/Relocation position). Office location is - HI-Wailuku-285 Mahalani St.-Maui Memorial - Cottage Buildings (HI050-A)
Duration: 12mo (Very high possibility to convert to FTE after 3mo. They explicitly stated this to me over a meeting.
Job title: HIM Hospital Coder I - This is for an outpatient coder, not inpatient - 3 headcount needed here.
All work is performed in accordance with the rules, regulations, and coding conventions as established by the American Hospital Association (Coding Clinic), ICD-10, CMS, OSHPD, and Kaiser organizational/institutional coding guidelines.
Education/License/Certification:

• This position requires a Certified Coding Associate (CCA) and eligibility to become a Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).
• Completion of classes in medical terminology, anatomy and physiology, ICD-10 and CPT coding conventions, and disease process from an accredited program. Must have high school diploma or GED.

Qualifications:

• Must have two years of continuous hospital experience in coding/abstracting within the last five years.
• Demonstrated ability to understand the clinical content of a health record.
• Demonstrated ability to communicate with physicians in order to clarify diagnoses/procedures and sequencing of diagnoses.
• Must be able to meet quantity and quality standards established for Coders I.
• Basic PC skills.
• Must attain a grade of 75% on the Kaiser coding test. (Will be given after the interview if they like the candidate).
• Must maintain a minimum of ten (10) CE units annually. Must maintain current coding credential.
• Will abide by the AHIMA coding code of ethics.

Duties:

• Review medical records to identify diagnoses/procedures.
• Under general supervision, organizes and prioritizes all work to ensure that records are coded in timeframes that will assure compliance with regulatory requirements.
• Demonstrates knowledge of all procedures concerning the sequencing of diagnoses, procedures as outlined in but not limited to ICD-10-CM, CPT, Uniform Hospital Discharge Data Set, Medicare guidelines and other appropriate classification systems.
• Demonstrates knowledge of anatomy and physiology to interpret general medical classifications for coding outpatient encounter or inpatient discharge data.

The above duty statements are intended to describe the general nature and level of work being performed by individuals assigned to positions in this classification and, as such, are not intended to be construed as an exhaustive list of duties, responsibilities and skills required of every position so classified.
Assigns Codes:
Under direct supervision:

• Codes all diagnostic and operative information from the medical record using ICD-10-CM, CPT, HCPCS level 2 coding classification systems.
• Selects the DRG for each inpatient case.
• Reviews DRG discrepancies from the fiscal intermediary to ensure the appropriate per case DRG assignment.
• Verifies and abstracts all medical data from the record to complete a data abstract on hospital encounters. Corrects data as appropriate.
• Ensures that all data abstracted and/or coded are consistent with guidelines outlined by JCAHO, OSHPD and CMS, regional and local policy.

Completion of Medical Records:

• Under general supervision, interacts with physicians to clarify and accurately document patient diagnostic and procedural information.
• Enters patient information into the computerized inpatient and outpatient medical record databases, ensuring the accuracy and integrity of the medical record abstract or encounter data prior to transmitting case.
• Ensures timely record availability by meeting coding and abstracting productivity / quality standards established for Coders I.
• Participates in medical record documentation auditing to monitor physician compliance with regulatory requirements i.e., Physician Review Project.

Confidentiality/Security of Systems:

• Maintains and complies with policies and procedures for confidentiality of all patient records.
• Demonstrates knowledge of security of systems by not sharing computer logons.

Corporate Compliance Accountability:

• Consistently supports the precepts of corporate compliance and Principles of Responsibility by maintaining confidentiality, protecting the assets of the organization, acting with integrity, reporting observed fraud and abuse and complying with applicable state, federal and local laws and program policies and procedures.

Other duties:

• Answers the telephone promptly and identifies themselves and the department.
• Acts as a resource person to other hospital departments regarding coding questions and issues.
• Other duties as assigned by supervisors.

Top Three things Worker will be doing:

• Reviewing charts to code
• Contact providers on feedback
• Working the coding edits

Top Three Skillsets needed:

• Strong knowledge of medical coding system
• Attention to detail and analytical skills
• Critical thinking, compliance, and regulatory knowledge

Is there a possibility of extension in assignment? Yes
Is there a possibility of conversion to FTE? Yes
From HM: is all stuff I am looking for:

• To be able to hit the ground running, with minimal training.
• They are looking for a coder with A LOT surgical coding background.
• Multiple years of exp.
• Confident and calm in her answers as Sunny is looking for someone who is NOT timid.
• Mention good references and have them on hand.

EXCEL experience is a very big plus:

1. Maybe a small pivot table creation
2. Inserting, deleting, color coding
3. Very simple stuff

The Queen's Medical Center and HPH are hospitals where they have seen people who are really good.
Coding certification from AHIMA and AAPC.
They're looking for someone who can understand E/M coding in all areas.
They are only entertaining candidates in Hawaii because they work with the Union.